Responding to stroke

Trinity Hospital hires coordinator to help promote stroke effort

June 20, 2011

Registered nurse Jerilyn Alexander has been named stroke coordinator for Trinity Hospital.

Alexander's selection is part of a broad-based effort to enhance the hospital's response to stroke cases in collaboration with the North Dakota State Stroke Program.

As stroke coordinator, Alexander's efforts are focused on fine-tuning the hospital's policies and procedures to ensure that patients are treated quickly. With all stroke patients, time is of the essence.

"We have three hours from the time the symptoms start to deliver clot-busting drugs," Alexander said. "The more quickly patients are treated, the better the outcome. The longer the clot sits there, the more tissue becomes damaged."

The focus of Trinity Hospital's stroke coordination is developing stroke alert, or establishing protocols and guidelines caregivers use to respond to a stroke patient; pursuing a Stroke Center of Excellence and Advanced Stroke Certification by the Joint Commission; following up on patients; and establishing a team effort among caregivers to achieve effective stroke response.

As part of that effort, currently the radiology process is being streamlined to respond to stroke patients.

"We want the patient to have a CT scan right away," Alexander said. "That scan will show whether the problem is a bleeding stroke or a blockage in the brain. If it is a blockage, the patient will proceed to having an MRI."

"With our acute stroke protocol, patients will be in the MRI scanner for only 10 minutes," she added. "It's a quicker MRI, where the pictures that are needed will be picked out right away."

Other steps will include educational efforts with staff at Trinity, at rural hospitals and rural ambulance services; and educational efforts with patients and their families.

As part of staff education, Alexander explained, nurses will be becoming more familiar with clot-busting medication and patient procedures in the event of a stroke. Other efforts will include rural hospital education on screening for stroke patients and transporting patients to tertiary healthcare centers immediately, and updating rural ambulance services on identifying stroke through a stroke scale.

Working with patients

Alexander will also work closely with patients and their families.

"My job (as stroke coordinator) is the perfect opportunity for face-to-face time, visiting with patients on how they are feeling, and working on getting them the services that they need," Alexander said. "We have all of our follow-up services in place now, but I can coordinate that and make that process smoother."

"We are also hoping to start up a support group for stroke survivors and their families, so they can share ideas and thoughts," she added. "I would be spearheading that process."

Alexander also hopes to provide more public education on recognizing the signs of stroke, and prevention measures people can take if they have risk factors for stroke.

As part of Trinity's stroke care efforts, patients who have had a stroke will be added to an American Heart Association database. The database will help by gathering information on treatment procedures and follow-up care. The information will then be used to further streamline policies and procedures.

"We will continue to learn from individual cases, because no two strokes are the same," Alexander said.

Trinity's efforts at continuing to improve and streamline stroke care remain important as more, and younger, individuals suffer from stroke. The hospital currently sees between 10 and 15 stroke patients a month.

"Stroke is a leading cause of disability, and now that we're seeing strokes in people at even younger ages (such as people in their 40s), that's a lot of years of productivity lost," Alexander said.